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dissociative episodes symptom of sza?

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I had a psychotic break in 2003 and was diagnosed bipolar. That was changed to schizoaffective in May of this year. I've been having problems with delusions. Right now, I can put my strange thoughts aside (mind control, being watched and filmed, hypnotized and programmed), but I'm not sure what to believe.

I've also had mild dissociative episodes (depersonalization/derealization) for as long as I can remember. They used to scare me. I don't think it's gotten worse with the medication, but I notice it more now. My therapist said it may be causing me problems because it's not working for me anymore.

The diagnosis of depersonalization disorder requires that the depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

Anyone else have depersonalization episodes due to schizophrenia? What do you do? How do you stay in the present?

I feel like I'm waking up from a dream and suddenly everything is real. I ground myself by looking around and making sure I know who and where I am. Touching things help me stay grounded, too. I always know where I am and I don't lose time.

I posted on the dissociative disorders forum, but I was wondering if I could get any more input here.

My therapist told me to remind myself through the day that things are real. The problem is that when I do that I feel the same as I do when I come out of an episode. I feel disoriented and like things are suddenly real. I wonder if I'm detached more often than I realize.

My therapist had me keep track of how often I dissociate. It was like 8 times/day. It's hard to discern because it's subtle.

I stopped working 3 years ago. I'm home alone, a lot. I think the time I spend in my head makes it worse. I force myself to go to a bipolar support group one night a week so that I will socialize. Social situations, being tired, and anxiety trigger the depersonalization.

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You say you had your first beak in 2003, but you have always dissociated... so it doesn't occur exculesively in a psychotic disorder, it came before... so may be seperate?

I'm just musing... heads bit of lately, so I could be babbling

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Is there a standard treatment for depersonalization? Is it any different if it's a symptom of sza?

I get triggered by anxiety, social situations, and when i'm tired, but it can happen at anytime.

I take lexapro which helps me with anxiety. I take 2 anti-psychotics which help me with delusions, my pdoc says they might help with dissociation, too. I also take a mood stabilizer.

I'm in therapy, and we've started talking about dissociation. My tdoc tells me to keep reminding myself things are real.

Is there anything specifically that I can work on in therapy.

I had some childhood trauma that I don't think had a big effect on me, but my therapist thinks it did. That I'm holding back feelings.

Does working through trauma help with dissociation?

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I never dissociated until I started therapy.

Fuck that shit.

Therapists are creepy or ineffective or just plain dumb. My opinion only.

No offense to you Confused if you find it works for you then great. Therapists are BIG on childhood trauma.

Telling you things are REAL when you are psychotic and feel the opposite does not work. Better your therapist agree with you on how scary it all feels. Then you will feel like the professional understands and can relate. That would help more than anything else by having your experiences validated.

If depersonalization and/or dissociation is happening seperate from scizo symptoms then YES it is an entirely seperate thing and telling you that you and your feelings are REAL is helpful. At the time you may not know which situation it is and it is possible the therapist does not know either. Try getting him or her to admit that!?! Try antipsychotics and see what symptoms they help if any. The time I found a therapist most helpful was when I was psychotic and that is supposed to be when a therapist is least likely to be helpful and a psychiatrists intervention more effective. Trial and error my dear. Never stop trying to see what helps.

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